GMC Number: 4304423

Year of first qualification: 1996

Specialty: Rheumatology & Osteoporosis

Clinical interests: General rheumatology, osteoporosis, metabolic bone disease

Secretary: Jessica Goodwin

Telephone: 0117 414 2849

Professor Emma Clark is active across all adult general rheumatology services.

Professor Clark has a particular clinical interest in osteoporosis and hypermobility. She runs a dedicated osteoporosis/metabolic bone disease clinic.

She leads on the vertebral fracture assessment (VFA) component of the DXA service.

She is also an active researcher through her post as Reader in Rheumatology, Bristol Medical School, University of Bristol. She runs three research programmes: vertebral fractures, scoliosis and hypermobility.
 

Urology Clinical Research Lead

Jonathan Aning, Consultant Urological Surgeon. 
 

Researchers

Professor Paul Abrams, Consultant Urological Surgeon.
Professor Nikki Cotterill, Professor in Continence Care.
Anne Fee, Specialist Clinical Researcher
Andrew Gammie, Clinical Engineer
Kathryn Jones, Research Associate
Nicola Morris, Laboratory Research Manager
Alan Uren, Specialist Clinical Researcher

Research Nurses

Rebecca Cousins, Lead Urology Research Nurse
Marta Cobos-Arrivabene, Urology Research Nurse
Victoria Garner, Urology Research Nurse
Caroline Jones, Urology Research Nurse

 

 

Consultants

Salah Albuheissi (Clinical Lead)
Jonathan Aning
Stefanos Bolomytis
Helena Burden
Hugh Gilbert
Andrew Harris
Hashim Hashim
Motaz Hassan
Odunayo Kalejaiye
Frank Keeley
Anthony Koupparis
Su-Min Lee
Ahmed Mahrous
Aditya Manjunath
Caroline Ochoa Vargas
Raj Pal
Joe Philip
Farukh Qureshi
Edward Rowe
Ala'A Sharaf
Anthony Timoney
Katherine Warren 
Tim Whittlestone
Zsuzsanna Zotter

 

Cancer Nurse Specialists

Cate Abbey
Helen Chilcott
Sarah Fletcher
Gillian Smith
 

Clinical Urology Nurse Practitioner

Jasmine King

Urodynamics & Functional Urology Team

Professor Hashim Hashim (Director)
Carolina Ochoa Vargas
Ala'a Sharaf
Alex Bacon
Connie Chew (Nurse)
Dr Andrew Gammie (Clinical Scientist)
Anna Hassine
Shiby Priju (Nurse)
Dr Laura Thomas (Urodynamics Manager)
Rachel Tindle (Clinical Scientist)

 

Consultant Oncologists

Amit Bahl
Amar Chalapalli
Susie Masson
 

Prostate disease is the term uses to describe conditions that can affect the prostate gland.

These can be:

• prostate enlargement
• inflammation of the prostate gland (prostatitis) 
• prostate cancer 

Prostate enlargement

Prostate enlargement is a common condition especially in around a third of men over the age of 50.

If the prostate becomes enlarged it can put pressure on the urethra (a tube that runs from the bladder through the prostate) and make is difficult to pass urine

Symptoms of an enlarged prostate

• difficulty when starting to urinating
• weak flow of urine
• having to strain to pass urine
• peeing more frequently
• having to get up and pee at night

In the first instance it’s recommended that you reduce the amount you drink before bed to see if that eases the symptoms.
Medications, such as alpha blockers, are available to help reduce the size of the prostate and relax the prostate gland muscles.

Only if medication doesn’t ease the problems is surgical intervention an option. The inner part of the prostate gland that’s causing the blockage is surgically removed.

Find out more about prostate enlargement.

Prostatitis

Prostatitis is a condition where the prostate gland becomes inflamed. This can occur as a result of an infection although in most cases no evidence of infection is found.

Symptoms of prostatitis include:

• pelvic pain
• testicular pain
• pain when urinating (usually associated with a urinary tract infection)
• pain when ejaculating semen
• pain in the perineum (the area between the anus and back of the scrotum). This can be worse when sitting.

Prostatitis is treated by a combination of painkillers and medication known as an alpha-blocker.

Find out more about prostatitis.

Firstly, the most important thing to note is that everyone with a bladder problem can be helped and many can be cured.

Urinary incontinence is the  release of urine unwillingly. It can affect both men and women and there are a number of reasons for this and there are also a number of ways it can be treated or managed.

The Continence and Urodynamics Unit at the Bristol Urological Institute (BUI), is a centre of excellence with a national and international reputation in the assessment and treatment of  urinary incontinence. The unit offers secondary and tertiary regional, national and international services for urinary incontinence. Urinary incontinence comes under the umbrella of female urology, neurourology and urodynamics, often termed functional urology.

Clinicians, specialists nurses, continence advisors and physiotherapists come together to run a dedicated incontinence clinic at the BUI.

The service is led by a team of three clinical experts, Prof Paul Abrams, Prof Marcus Drake and Mr Hashim Hashim, who have gained an international reputation for their dedication into developing new diagnostic tools, treatments and devices to help those suffering from what was seen as, until recently, a taboo and unmanageable disease.

Types of Urinary Incontinence

Stress incontinence
This type of incontinence actually does not have anything to do with emotional stress but is related to pressure to the bladder such as being overweight, pregnancy, sneezing, lifting heavy objects, exercise and some medical conditions. Leakage is due to a weakness of the pelvic floor that supports the bladder and the urethra. It is often termed ‘ effort’ incontinence.

Treatments for stress incontinence in women
Non-surgical treatments include:

• Restricting fluid intake
• Stopping smoking
• Reducing weight
• Pelvic floor exercises
• Medications such as Duloxetine

For more information about these treatments visit www.nhs.uk/Conditions/Incontinence-urinary/Pages/Treatment.aspx

For 1 in every 3 women with symptoms of stress incontinence these non-operative treatments can make symptoms much better or cure them completely.

Surgical Treatments for Stress Incontinence at BUI
Surgical treatments include:

• Injection/Bulking agent treatment
• Sling procedures (Natural and Synthetic)
• Colposuspension
• Artificial Urinary Sphincter

For more information about these treatments visit www.nhs.uk/Conditions/Incontinence-urinary/Pages/Treatment-surgical.aspx

Operations for stress incontinence depend on supporting the urethra. There are several  operations to cure this type of leakage, and the BUI is one of the few centres in the United Kingdom that can offer all these treatments. According to the National Institute of Clinical and Health Excellence (NICE), women with stress incontinence should be offered all forms of treatment and not restricted to one type. NICE also recommend that women are discussed in a multidisciplinary team meeting. The surgeons at the BUI are also experts in dealing with tape complications and are the regional centre for such treatments.

Stress Incontinence in Men
The most common reason for men having stress incontinence is due to treatment for prostate cancer. Surgery and radiotherapy can weaken pelvic floor muscles and the urethral sphincter (a ring of muscle that keeps the urethra closed)

Non-surgical treatments include:

• Pelvic floor muscle training (PGMT)
• Bladder retraining
• Medicines

Surgical treatments include:

• Artificial sphincter
• Male Sling
• Urethral bulking
• Penile clamp

For more information about these treatments visit www.nhs.uk/Conditions/Incontinence-urinary/Pages/Treatment-surgical.aspx

Urgency incontinence and overactive bladder (OAB) syndrome
This type of incontinence is characterized by a strong urge to urinate with no ability to stop it and often leads to leaking before reaching the toilet in time. It can affect about 12% pf the population with no known cause or it can be caused by as a result of an injury to nerves or muscles which help control urinary flow but it can also be caused by some medical conditions.

The doctor/nurse will ask you questions about the problem and your general health. He/she may do a physical external examination, perform an internal examination and a urine test will be done to check for infection. You will be asked to complete a 3-day frequency/volume chart to record the time of voiding and volumes of urine passed. A flow test may also be performed. This is a test which involves passing urine into a special machine to measure the strength of flow and to check whether the bladder has emptied completely.

If the symptoms fail to respond to conservative and medical treatment a more invasive investigative test may be performed called urodynamics. This is a special test to measure pressures inside the bladder.

Treatments:

• Change of drinking habits
• Bladder training
• Medication
• Surgery

Surgery for Overactive Bladder
The surgeons at the BUI are the only centre in the South West of England that can offer all forms of treatment for refractory overactive bladder syndrome including Botox injection in the bladder, Sacral nerve stimulation, and major surgery.

Pelvic Organ Prolapse
Mr Hashim is one of a few urologists in the United Kingdom who is fellowship trained in pelvic organ prolapse repair in women and also works closely with urogynaecologists and colorectal surgeons at Southmead Hospital to offer a first-class service for women with prolapse.

Pelvic organ prolapse is the bulging of one or more of the pelvic organs (uterus, vagina and bowel) into the vagina. Pelvic organ prolapse can affect the front, top or back of the vagina.

Symptoms are:

• the sensation (feeling) of something coming down or protruding of the vagina
• discomfort during sex
• problems passing urine 

Some women with a pelvic organ prolapse don't have any symptoms and it’s only discovered during an internal examination such as a cervical screen.

Pelvic organ prolapse isn't life-threatening, but it can affect your quality of life.

The main types of prolapse are:

• anterior prolapse (cystocele) – where the bladder bulges into the front wall of the vagina
• prolapse of the uterus and cervix or top of the vagina – which can be the result of previous treatment to remove the womb
• posterior wall prolapse (rectocoele or enterocoele) – when the bowel bulges forward into the back wall of the vagina

It's possible to have more than one of these types of prolapse at the same time.

Genito-urinary Fistula
A fistula is an abnormal communication between the bladder and the vagina or the urethra and the vagina. This causes women to leak continuously. The BUI surgeons are trained in vaginal and abdominal vesico-vaginal and urethro-vaginal fistula repairs and offer a regional and tertiary service for such repairs.

Andrology & Male Urethral Reconstruction

Andrology is a subsection of Urology which deals with problems affecting the male reproductive system. These conditions may present as emergencies or through our outpatient clinics.

We currently have an experienced team of 4 consultants and a senior specialist Andrology nurse with over 15 years of experience.

We provide care for the whole or Bristol and act as a tertiary referral centre for South-West England.

We also have a long tradition of research following on from the Dr Gingell who did the original UK research on Viagra.

In addition, we have had 4 MDs in collaboration with the cardiac institute researching the various factors causing erectile dysfunction.

Andrology Team

Prof Raj Persad
Mr Salah Al-buhessi
Mr David Dickerson
Mr Rupert Beck
Miss Wendy Hurn

We manage the following conditions:

Priapism
This is an abnormal prolonged erection which requires emergency treatment.

Penile fracture
This is due to a tear in the lining (tunica albuginea) of the penile erectile apparatus. This requires emergency surgical treatment.

Torsion
This is a twist in the tube from which the testis is suspended (spermatic cord). This results in the blood supply to the testis being cut off. It requires emergency surgery to untwist the spermatic cord rapidly or it results in loss of the testis.

Genito-urinary trauma

Erectile dysfunction
This is an inability to either develop or sustain an erection sufficient for sexual intercourse. It is common and often very distressing. It may be due to medical conditions such as diabetes or following surgery for cancer.

Ejaculatory disorders including premature ejaculation
This is an abnormality of the expulsion of semen. It is a very distressing condition and is probably the most common sexual dysfunction in men.

Penile curvature
This condition is either present lifelong (congenital penile curvature) or may develop over time (Peyronie’s disease). Peyronie’s disease is due to scarring of the tunica albuginea thereby creating a plaque.

Urethral stricture disease
This is a scarring condition of the male waterpipe (urethra). This results in difficulty passing urine and emptying the bladder.

We also offer the following treatments:

• Penile prosthesis
  This may be inserted electively or as an emergency. The indications are for end stage erectile dysfunction, prolonged priapism or severe penile curvature associated with erectile dysfunction.
• Surgery for penile curvature
  This is either a Nesbitt’s plication or a Lue procedure. The aim of both procedures is to create a straight and functional penis. Nesbitt’s involves the excision of part of the penile tissue. A Lue involves incision of the Peyronie’s plaque and the insertion of a graft.
• Urethroplasty
  This is the excision and repair of the urethra which has been affected by stricture disease. This may involves the insertion of a graft.
• Penectomy and penile reconstruction
  This is the excision of some or all of the penis due to cancer. Where only part of the penis has been removed, we also offer surgery to re-fashion the penis so it looks as close to normal as possible. This is penile reconstruction. Penile reconstruction may also be offered where the penis or foreskin has been affected by non-cancerous conditions.

Men with non-emergency conditions may be referred to us via their GP through NHS eReferrals to our andrology clinics either at Southmead or at South Bristol.

Useful Links

Sexual Advice Association: www.sda.uk.net
NHS UK: www.nhs.uk/livewell/goodsex

The specialist stone unit at the BUI, Southmead Hospital, Bristol,  provides services for Bristol, the surrounding region, and as a tertiary referral centre for South West England.

After clinical review, our expert stone surgeons suggest management plans that are individually tailored to you, the patient. Management decisions are typically based upon stone factors (type, size and location), kidney factors (number, function, previous surgery) and patient factors (other illnesses or factors that may make surgical intervention higher risk).

The stone services offered through the specialist stone unit includes:

Onsite extra-corporeal shockwave lithotripsy (ESWL)

This treatment uses machine generated shock waves to break up urinary stones. The treatment sessions are carried out as daycase procedures and last for approximately 30 minutes. You should be sent home within 2-4 hours. The stone unit has an onsite lithotripter and a dedicated lithotripsy team who meet weekly to plan stone treatments. We offer an emergency shock wave lithotripsy service and are involved in national trials in stone treatment.

Uretero-renoscopy and laser lithotripsy

This treatment is carried out under a general anaesthetic and involves a thin camera is passed through the urethra, bladder and into the ureter and/or kidney. A tiny laser is then passed through the camera and is used to break up stones into smaller pieces. These procedures are typically carried out as daycase. You may have a plastic tube (stent) left inside to help protect the drainage of the kidney after this procedure.

Percutaneous nephrolithotomy

This treatment is carried out under a general anaesthetic and involves a small incision in the skin near the kidney affected by kidney stones. A needle is then inserted into the kidney by an interventional radiologist under ultrasound guidance. The needle entry is then stretched enough to allow a special camera instrument to pass into the kidney and retrieve the stone fragments. This type of treatment is typically reserved for larger kidney stones (greater than 1.5-2 cm) or stones which are difficult to access with a flexible uretero-renoscope. Following this procedure you would typically stay in hospital for 1 to 5 days.

Laparoscopic and open renal stone surgery

This treatment is rarely used and is always carried out under general anaesthetic. Laparoscopic surgery involves multiple keyhole incisions in the abdomen. An open operation involves a large incision (10-15 cm) over the flank, to expose over the site of the kidney or ureter. This treatment maybe offered, for exmaple, if other stone treatment methods have not been successful or there is little or no remaining kidney function in a kidney with stone disease.

Metabolic stone service

We work alongside our colleagues in the renal (kidney), biochemistry and microbiology departments in order to identify reasons why patients form recurrent kidney stones. The aim of metabolic tests is to prevent stone recurrence.  

This page has information about the Urology One Stop Clinic. 

What is the clinic for? 

The Urology One Stop Clinic aims to help patients have consultations and tests all done in one visit. This is more efficient for you and us. 
You may see different members of the multidisciplinary team (MDT) including doctors, specialist nurses and radiographers. 

How soon will I be seen? 

You must be referred by your GP. If you are referred because your GP suspects you might have cancer, we try to see you within 2-3 weeks of your referral. This is often called a “fast-track referral.” For other referrals we aim to see you within 6-8 weeks. 

Before your visit 

• You may be sent some leaflets or forms to complete in the post or by text. Please read them carefully.
• Your letter may ask you to arrange or some blood or urine tests at your GP. It is important you do this so we have the results ready for your appointment.
• If you are going to have a CT scan, you may be advised to drink water or not eat for a few hours before this. Please check your letter for instructions.
• Please bring a list of any medicines you take including ones you buy yourself such as herbal remedies.
• It can be useful to bring someone with you to appointments. 

During your visit

You will usually see a doctor or nurse first, and they may then send you for some tests or scans. Some will be on different days.  These may include:

• Urine tests.
• Blood tests.
• Flow rate tests.
• Questionnaires about your symptoms.
• Flexible cystoscopy.
• Ultrasound.
• X-rays.
• CT scan.
• MRI scan.

If you need surgery: 

• You may be asked to go to one of our pre-assessment clinics to check you are fit for the procedure. This might include tests like an ECG (heart trace), blood tests, and X-rays.  

Questions to ask

When you come to your Urology One Stop appointment, you may have a lot of questions. It is normal to find it difficult to remember things at the time of and after your appointment so here are some tips to help you.  

Before your appointment

During your appointment

After your appointment - don't forget the following

Tests, such as blood tests or scans

What next?

© North Bristol NHS Trust. This edition published June 2025. Review due June 2028. NBT003478.

For elective surgery, patients are asked to report to Theatre reception at Gate 21, Level 3 in the Brunel building, Southmead Hospital.

Patients who require a hospital stay after their surgery (inpatient) will be transferred from to Ward 34b which is a dedicated urology ward.

GMC number: 6041454

Year & location of first qualification: 1994, Gulburga University, Karnataka, India

Specialty: Infectious Diseases and Microbiology

Clinical interests: Infection, Antimicrobial therapy, pharmacokinetics/pharmacodynamics of antimicrobial therapy, sepsis.

Secretary: Josephine Poad

Telephone: 0117 414 6273

Member of Royal College of Physicians, London
Member of Royal College of Pathologists, London
Member of British Infection Association
Member of British Society of Antimicrobial Chemotherapy
Member of European Society of Clinical Microbiology and Infectious Diseases